Directorate of Radiation Control progress: Department of Health briefing; bail-out strategies for provincial departments that exhaust funds before end of financial year: National Treasury briefing

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Health

21 June 2011
Chairperson: Mr B Goqwana (ANC)
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Meeting Summary

The Department presented its progress on radiation control. The Ministerial Task Team had only met once since its last presentation to the Portfolio Committee, and therefore not much progress had been made.

Various questions around the progress of the Task Team, the accuracy of the Department’s databases, and South Africa’s compliance with international regulations were generally left unanswered because the Chairperson felt that the correct person to answer the questions posed was absent. Questions would be replied to in writing.

National Treasury briefed the Portfolio Committee on the spending patterns in provincial health departments. It emerged that over-spending had been replaced by under-spending in 2010/11, especially in terms of capital assets. Personnel spending was the only segment to rise. The positive example of the turnaround in KwaZulu-Natal, where there had been a definite turnaround in spending patterns without sacrificing service delivery, was repeatedly cited.

Due to time constraints, many Members’ questions and comments were left unanswered.

Meeting report

Presentation by the Department of Health
The Director-General, Department of Health, tendered apologies.

 Ms Emma Snyman, Deputy Director: Radionuclides, Department of Health, briefed the Committee on the background of the Ministerial Task Team’s progress towards controlling radiation, including the regulatory infrastructure, mandates, legislative frameworks and regulatory oversight in terms of the Directorate of Radiation Control. There were three regulators involved in radiation protection in South Africa: the Department of Energy: the National Nuclear Regulator and the Sub-Directorate: Nuclear Safeguards as well as the Department of Health’s Directorate of Radiation Control.

Ms Snyman commented on the mandate of the Ministerial Task Team, which related to the Hazardous Substances Act 1973 (Act No. 15 of 1973), Group IV. The Sub-Directorate of Radio-nuclides regulated approximately 2 700 authority holders and 15 000 sources of radiation. Medical applications consisted of approximately 10%; industrial applications comprised approximately 90% of the work of the Sub-Directorate.

Short term terms of references included: establishing a common radiation source register, a national dose register, carrying out the code of conduct on the safety and security of sources, processing national comment on the International Atomic Energy Association (IAEA) safety standards, sharing information, and finally the disposal of radioactive sources.

Ms Snyman commented that South Africa was one of the first countries in the world that had established a national source register. However the source register was currently inaccurate. There were several dose registers, but the Department was in the process of combining them into one national register.

Medium term references included the implementation of the self-assessment tool. These would take approximately three years. Long term terms of reference related to reviewing overlaps and capacities in terms of legislation and regulatory mechanisms. Ms Snyman noted that the Act was good; however there were small updates that were required.

Ms Snyman outlined the members and stakeholders involved in the Task Team. The first meeting was held on 21 February 2011. The Agenda, Minutes, and Discussions were outlined. Interventions decided upon included: identification of shortcomings in the regulatory infrastructure; developing a national dose register; and staff recruitment for the Directorate of Radiation Control. All vacant posts in the Inspectorate Sub-Directorate had been filled, however there was an unresolved issue in the Sub-Directorate of Radio-Nuclides.

The agenda of the next meeting of the Task Team on 13 July 2011 was outlined.

Discussion
The Chairperson commented that the Director-General was unable to attend, and that this led to problems of oversight.

The Chairperson noted that Ms Snyman might not be able to answer some of the questions that had been posed. It also seemed as if the Departments of Health and Energy had not established where their own working areas were. There was significant debate between the Members about whether or not Ms Snyman was in fact the correct person to answer the questions that were asked.

Mr M Hoosen (ID) asked what the current status was in terms of accidental exposure to radiation.

Ms Snyman stated that there was a lapsed national register. Many bodies failed to report within South Africa. Two South African bodies had to report to the IAEA. However, most accidents were not reported in South Africa, so Ms Snyman did not have an accurate number.

Mr G Leketho (ANC) asked for further information regarding Ms Snyman’s Sub-Directorate.

Mr M Waters (DA) commented that there were 239 lost sources of radiation last year. There seemed to be a lack of a sense of urgency because the Task Team had only met once.

The Department asked for the Committee’s indulgence, but noted that some of this work would be completed by July in terms of the lost sources, especially high risk cases.

Mr Waters noted that South Africa seemed to be failing in its international obligations and wanted to know what the consequences for the country were in terms of the IAEA.

Mr Waters wanted an update on further lost sources of radiation.

Mr Waters asked for further information on why some lost sources had escaped regulatory control.

Mr Waters asked Ms Snyman to update the Committee on her sub-directorate’s staff recruitment.

Ms Snyman noted that,t when she was recruited, the post had not been filled for over three years. There was one vacancy for a post of senior scientist post in the sub-directorate of Ionizing Radiation, three vacancies for Senior Radiation Scientists, and one senior scientific administration officer in the Sub-Directorate of Radio-nuclides.  In the regional offices there were five vacancies. Staffing and recruitment was a challenge because of extensive training and experience required.

Ms Snyman stated that inspectors were also limited by the inaccuracy of the databases involved.

Ms Snyman commented that many long term vacancies had been advertised on numerous times. However, there were problems in terms of the parity between post levels between national and provincial posts.  A submission had been made to the Minister through the Director-General in that regard.

Mr Waters was concerned that the Sub-Directorate had deteriorated and that the register was out of date. He proposed that an investigation into this Sub-Directorate be held.

Ms E More (DA) asked what the progress was on the employment of a medical physicist.

Ms More commented that it seemed as if everything was in the planning phase, and that action seemed not be occurring.

Mr More asked whether or not there was an investigation into the lost sources of radiation.  What was the status of tracing those lost sources, and possibly prosecution of those responsible?

Mr D Kganare (COPE) raised the fact that consultants were mentioned in the Department’s presentation. Was there no capacity? In what circumstances were consultants being employed?

Mr Kganare commented that it seemed as if this Task Team was very large, and that including more stakeholders seemed strange as there were already many stakeholders included.

Mr Kganare noted that in terms of international regulation it seemed as if the Directorate was very good at compiling regulation, but implementation seemed to be a problem.

Ms Ngcobo (ANC) noted that the Committee needed to speak to the Director-General.

Ms M Segale-Diswai (ANC) informed the Committee on a company that worked with the Department of Health, possibly called AECI, and wanted to know what the relationship was.

Ms T Kenye (ANC) wanted further information about the vacant posts in the Department.

The Chairperson, despite opposition from some Members, decided that the discussion would be adjourned due to the fact that the correct people were not able to adequately answer those questions. Mr Waters and Mr Hoosen were both vocal in their desire for Ms Snyman to answer the questions that she could. The Director-General and Ms Snyman would be called to appear before the Committee in future, and the questions asked in this Committee meeting would be answered in writing by the Department.

National Treasury. Provincial Health Expenditure
Ms Wendy Fanoe, Chief Director: Intergovernmental Policy and Planning, National Treasury, briefed the Committee on Provincial Health Expenditure. Overall, large over expenditure in 2009/10 had been displaced by under expenditure in 2010/11. Ms Fanoe highlighted the under-expenditure in terms of capital assets, which was a problem. There was over expenditure on every other category.

In 2010/11 Gauteng and the North West were guilty of over-spending, however seven provinces under spent. Ms Fanoe commented on the positive turnaround that the KwaZulu-Natal Department of Education had in terms of spending patterns. There had been positive action by the provincial Department that had resulted in far better spending patterns.

Year-on-year comparisons indicated that expenditure on personnel was rising faster than all other items.

Ms Fanoe highlighted the large overspending in terms of personnel in Gauteng in 2010/11. Ms Fanoe briefed the Committee on the relationships between National and Provincial Governments in terms of spending, specifically related to sending conditional grants.

Ms Fanoe outlined some of the changes in the 2011 Division of Revenue Act as they related to health. The weighting has increased from 26% to 27%. Infrastructure Grants have been split between health, education and provincial roads and maintenance grants. Additionally, there had been an improvement of national oversight of conditional grants.

Specifically related to bail-outs, Ms Fanoe noted that over-spending in 2009/2010 was reversed to become under-spending in 2010/2011 of over R2 billion. These spending patterns happened despite accruals from 2009/2010.

Dr Mark Blecher, Director: Social Services, National Treasury, noted that bail-outs sent a poor message to different provincial departments. Some provinces, for example Gauteng, had employed 10 000 additional staff over two years without having a budget allocation.

KwaZulu-Natal had embarked on a turnaround project. Interventions helped to control tenders, procurements, corruption and other misconduct. Three finance bills had focussed on better controls and efficiencies and had resulted in a successful turnaround. Several other provinces had also been involved with the help of National Treasury, as well as Provincial Treasuries.

Ms Fanoe elaborated on the lessons learnt. Provinces needed to instil a culture of value for money. They needed to ensure that financial management is fully functional in the major expenditure centres, especially in health and education. Priority needed to be given to strengthening contract management. Human resource management needed to prioritise the appointment of clinical staff and control the ratio between service delivery staff and administrative staff. Infrastructure programmes needed to be concentrated on. There needed to be a recognition of the difference between under-spending as opposed to savings. Finally, provincial treasuries needed to act quickly when challenges occurred in terms of intergovernmental relations.

Discussion
The Chairperson requested information on whether or not the turn-around in spending patterns in provinces, for example in KwaZulu-Natal, adversely affected service delivery.

Ms Fanoe noted that the fat was cut and that the spending cuts had not resulted in adverse service delivery at all.

Ms Ngcobo asked about under-spending. Was it due to under capacity or another reason?

Dr Blecher added that the Department was very aware of this under-spending. The Minister was looking at using the Development Bank of South Africa as an alternate implementing agent to promote proper spending. Historically there had been a weakness in planning, but there were definite signs of progress.

Ms Ngcobo asked for more information about cash surplus. Was there a problem with planning?

National Treasury replied that cash was being managed better at a provincial level. This also related to planning and spending levels. The health sector had a definite problem in terms of spending on capital assets.

Ms Ngcobo asked whether grants allowed for virements.

National Treasury explained that this was not allowed as there was a national grant framework and procedures in place. The Department had to follow that framework and spend accordingly.

Mr Kganare commented on under-staffing in hospitals. Was there a formula to work out how many nurses or doctors were required per portion of population?

Dr Blecher commented on the equitable share formula review. Primary health care was being focussed on and was currently approximately R22 billion a year. Cross checks were made to build spending from a work load basis, based on staffing levels and populations too. This was a new approach that had looked at this problem. Mr Blecher noted that this was an important consideration. Some norms existed in Treasury, but that this would be looked at going forward.

Ms Fanoe noted that there was an overlap in terms of these responsibilities at national level and provincial level. Treasury had envisaged that there were oversight roles and posts on a provincial level. Ratios were also being developed by various departments.

Mr Kganare commented on the performance of the Department of Public Works. He was of the opinion that bail-outs should apply where Public Works had failed to deliver.

Mr Waters was pleased that provincial finances seemed to have improved to some extent. There seemed to be large swings between over-spending followed by under-spending.

Mr Waters wanted to know whether provinces still had overdraft facilities.

National Treasury answered that three provinces: Northern Cape, Eastern Cape and Kwazulu-Natal had these facilities. Northern Cape and KwaZulu-Natal had improved their overdraft status. Eastern Cape had not submitted its financial details so Treasury could not answer accurately for that province.

Mr Waters commented that the CFO who had helped the KwaZulu-Natal situation had returned to Treasury. Was the person remaining able to continue the good work?

Mr Waters requested information on which service providers were still owed money.

Mr Hoosen thanked the delegation for its thorough presentation.

Mr Hoosen noted that there was extensive monitoring and wondered how billions eventually were over or under spent.

Ms Segale-Diswai asked about over-spending on personnel, despite the existence of vacant posts. How are funds allocated towards personnel? Ms Segale-Diswai asked how Treasury was working with the Department of Health to employ support staff, with job creation in mind.

Dr Blecher noted that spending on personnel had gone up significantly. The public health sector was growing at between 10 000 – 15 000 per year and the sector now employed approximately 300 000 people. Human resource and planning for human resource needs were a definite priority for National Treasury going forward.

Ms Fanoe noted that appointing more staff than one needs helps no one. However SMMEs needed to be investigated to provide services. Economic growth needed to target SMMEs to develop our economy.

Ms Segale-Diswai commented on Treasury’s influence on the implementation of the NHI.

Ms More commented that training expenditure was increasing, but performance was not visible. Was this monitored at any level on the ground?

Ms Kenye commented on Occupational Specific Dispensation commitments in Education. Would Health be catered for?

Mr Blecher replied that there were unfunded mandates involved where costs were picked up at the provincial level, often when national government made policy. The sector needed to think through what the cost structures were. There had been a huge change towards personnel. Approximately R10 billion was spent on these programmes. It was not likely that this would happen again soon.

Ms Kenya noted that provinces, especially Gauteng, had poor spending patterns. What were Treasury’s plans to address this?

Due to time constraints, many questions were left unanswered.

The Chairperson adjourned the meeting.


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